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Pyogenic liver abscess: current status and predictive factors for recurrence and mortality of first episodes

Matías E Czerwonko1, Pablo Huespe1, Santiago Bertone1

  • 1Department of General Surgery, Hospital Italiano de Buenos Aires, Juan D. Perón 4190, C1199ABD, Buenos Aires, Argentina.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
|October 8, 2016
PubMed
Abstract

Insights

Pyogenic liver abscess (PLA) is increasingly linked to biliary issues or iatrogenic causes. Recurrence is predicted by cholangitis history, while mortality relates to high bilirubin levels and lesion distribution.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Surgical Outcomes

Background:

  • Pyogenic liver abscess (PLA) is evolving, with modern surgery, transplantation, and percutaneous techniques shifting its origins.
  • The diagnostic approach, clinical presentation, and therapeutic outcomes of PLA require further investigation.
  • This study focuses on the clinical and microbiological aspects of first-time PLA episodes.

Purpose of the Study:

  • To analyze clinical and microbiological features of first PLA episodes.
  • To evaluate diagnostic methods and therapeutic management strategies.
  • To identify predictive factors for PLA recurrence and mortality.

Main Methods:

  • Retrospective single-center study.
  • Inclusion of 142 patients with first PLA episodes (2005-2015).

Main Results:

  • Biliary diseases (47.9%) and non-biliary percutaneous procedures (NBPLA, 15.5%) were primary causes.
  • Liver transplant recipients accounted for 12% of cases.
  • Recurrence affected 13.7%, with multiresistant organisms and cholangitis history as risk factors.
  • Mortality (7.8%) was linked to high serum bilirubin (>5 mg/dL) and bilateral abscess involvement.

Conclusions:

  • NBPLA and post-transplant PLA may be rising in specialized centers.
  • A history of cholangitis is a significant predictor of PLA recurrence.
  • Hyperbilirubinemia and lesion distribution are associated with mortality in PLA patients.

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